Every year, millions of federal dollars flow into Wyoming, funding highways, education, air service, agriculture and more. But when it comes to providing access to health care for residents in need?

Then Wyoming lawmakers are inexplicably hesitant to accept federal money.

It appears the Wyoming Legislature again will refuse to accept federal dollars to expand Medicaid coverage in the state. That means upwards of 20,000 low-income adults will remain uninsured — unless legislators come up with other solutions.

Gov. Matt Mead has continued to urge legislators to expand Medicaid.

“We have tried to find a Wyoming solution to our health care. We have not,” Mead said in his state of the state address earlier this month.

Previously, Mead fought against the Affordable Care Act, and he said he still doesn’t like it. But unlike some state lawmakers, he’s been willing to face reality.

“We lost the legal battle, and we lost the political battle,” Mead said.

The governor posed the question: “What is the Legislature’s solution to address these issues?”

Like many in Wyoming, we’ve waited years for an answer.

And as we wait, thousands of Wyomingites have gone without health-care coverage.

The Legislature’s inaction over the years may make Medicaid expansion seem like it isn’t a pressing issue. But for thousands who cannot afford screenings, medications and treatment, the need is urgent.

Dozens of deaths could be prevented in Wyoming each year by providing access to health care through Medicaid expansion, according to the Wyoming Department of Health.

The Legislature’s inaction also impacts health-care providers.

By not expanding Medicaid, hospitals in Wyoming are stuck with $114 million or more each year in uncompensated costs for care, according to the governor.

Wyoming has a longstanding mistrust of the federal government, and we know state lawmakers worry the feds may not keep their promises.

But that concern hasn’t stopped Wyoming from continuing to accept millions of federal dollars for other programs.

Mead also told legislators they could set a condition: “We are out if the feds fail to live up to the deal.”

In recent days, instead of moving forward with Medicaid expansion, lawmakers have considered a variety of bills proposing alternatives for patients and health-care providers.

“There is no grand plan to take care of the folks who are left in the gap between currently eligible for Medicaid and eligible to be on the exchange and can’t afford insurance — there is nothing,” said Rep. Eric Barlow, R-Gillette, in a WyoFile article this week. “Now, we’re doing smaller things around it.”

While these alternatives may fill some access gaps, they fail to address major issues, such as insurance or helping people afford their deductibles and premium payments, Barlow said.

It’s time for lawmakers to stop piecing together small Band-Aid fixes and come up with a real solution — the problems are too great, and the stakes are too high. That’s particularly true in these periods of tight state budgets when Mead and the Wyoming Department of Health say expanded Medicaid will save millions that the state presently expends on duplicating programs.